• Pediatric Infection and Vaccine
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• v.16 no.1
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• pp.40-46
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• 2009

Purpose : The purpose of this study was to identify useful predictors for diagnosing bacterial meningitis and performing CSF studies in febrile infants three months or younger. Methods : Six hundred and fifty two febrile infants with a rectal temperature ${\geq}38.0^{\circ}C$ presented from January 2003 to April 2008 and were retrospectively studied. The total white blood cell count (WBC), band count, absolute neutrophil count (ANC), quantitative C-reactive protein (CRP) and blood cultures were performed on admission. The clinical variables associated with bacterial meningitis were analyzed. Results : In patients with bacterial meningitis, the clinical variables including CRP (P=0.036), band count (P=0.037), ANC (P=0.036) and age (P=0.001) were significantly different. The area under the receiver-operating characteristic curve was 0.969 for CRP, 0.946 for the band count, 0.765 for the ANC and 0.235 for age. A CRP cutoff point of 8 mg/dL was determined to maximize both the sensitivity and specificity (sensitivity 83%, specificity 95%, likelihood ratio 16.6). A CRP concentration of <7 mg/dL "ruled-out" bacterial meningitis, with a likelihood ratio of 0.17, a posttest probability of <0.1% and negative predictive value 91%. A CRP concentration greater than 9 mg/dL had a much higher likelihood ratio (20.1) than the band count (16.6) and ANC (2.2). Conclusion : The CRP concentration was a useful laboratory test for the differential diagnosis of bacterial meningitis among febrile infants three months of age or younger. A CRP concentration of <7 mg/dL effectively ruled out bacterial meningitis; a value ${\geq}9mg/dL$ increased the clinical suspicion of bacterial meningitis and the need for CSF evaluation.

• Pediatric Infection and Vaccine
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• v.24 no.2
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• pp.71-78
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• 2017

Purpose: The aim of this study was to identify the pathogens of blood stream infection (BSI) in children with hemato-oncologic disorders, to analyze susceptibility patterns of microorganisms to guide empirical antimicrobial therapy, and to compare temporal trends of the pathogen and antimicrobial susceptibility with those of previous studies. Methods: We retrospectively analyzed the medical records of children with hemato-oncologic disorders whose blood culture grew pathogens at the Seoul National University Children's Hospital between 2011 and 2015. Results: A total of 167 patients developed 221 episodes of bacteremia. Among 229 pathogens, gram-negative bacteria (GNB) accounted for 69.0% (64.0% in 2002 to 2005, 63.4% in 2006 to 2010); gram-positive bacteria (GPB) accounted for 28.8% (31.3% in 2002 to 2005, 34.6% in 2006 to 2010); and fungus accounted for 2.2%. Among GNB, Klebsiella species (53.2%, 84/158) and Escherichia coli (19.6%, 31/158) were common. Staphylococcus aureus (48.5%, 32/66) and viridans streptococci (21.2%, 14/66) were frequently isolated among GPB. The susceptibilities of oxacillin and vancomycin in GPB were 54.8% and 96.9% (51.5% and 95.5% in 2002 to 2005; 34.1% and 90.5% in 2006 to 2010), respectively, whereas in GNB, the susceptibilities of cefotaxime, piperacillin/tazobactam, and imipenem were 73.2%, 77.2%, and 92.6% (75.9%, 82.8%, and 93.4% in 2002 to 2005; 62.8%, 82.9%, 93.8% and in 2006 to 2010), respectively. There were no significant differences in the proportion of etiologic agents or the antimicrobial susceptibilities between the current study and that of the previous two studies from 2002 to 2010. Overall fatality rate was 13.1%. Conclusions: GNB predominated in BSI among children with hemato-oncologic disorders. The etiology of bacteremia and antimicrobial susceptibility were comparable to those of the previous studies. Thus, piperacillin/tazobactam can be used as the initial empirical antimicrobial agent in febrile neutropenia.

• Journal of Preventive Medicine and Public Health
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• v.35 no.2
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• pp.129-135
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• 2002

Objective : The primary objective of this study was to estimate the prevalence of HBsAg-positives in the late 1990's among Korean adults. In addition, we evaluated the association of age, a residential area, a vaccination rate, a family history of chronic liver diseases and a past history of acute liver disease with the seropositivity of HBsAg, and estimated the prevalence of chronic HBV infection by follow-up for 6 month or more. Methods : A total of 10 areas, six metropolitan and four small cities, were selected. In each cities, one health screening center was selected for recruitment of study subjects. The study subjects were enrolled from a general health examination program that is provided by medical insurance companies. Questionnaires on various risk factors were administered to the study subjects. Sera was drawn and tested for HBsAg by radioimmunoassay. HBeAg and ALT were also tested for those of HBsAg positive. The HBsAg positives was retest for HBsAg 6 months later Results : Among the study subjects (n= 1816), the seroprevalence of HBsAg was 5.5% (95% CI=4.5%-6.6%), 7.4% in men (95% CI=5.8-9.4) and 3.6% in women (95% CI=2.5-5.0). A past history of acute liver disease and a family history of chronic liver diseases was shown to be risk factors for HBsAg positivity. Among the 31 HBsAg-positives, negative seroconversion rate was estimated to be 3.2%, Thus, prevalence of chronic HBV infection was estimated to be 5.3% (95% CI=3.7-6.6). Conclusion : In this study, the HBsAg seroprevalence rate was lower than that of the other studies in 1980's, particularly in young adult and women. Considering the public health importance of liver cancer and chronic liver diseases, the further effort is needed to prevent and reduce the HBV infection.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.64-68
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• 2005

Purpose : Renal abscess is very rare in children and its diagnosis is difficult because symptoms are often nonspecific. In previous studies, on]y 15% to 25% of patients were reported to be diagnosed at the time of admission. Early diagnosis and treatment are important be cause mortality rate correlates positively with the time of diagnosis. The purpose of this study is to clarify the clinical features of children with renal abscess and to investigate the possible indicators of this disease for early diagnosis and Proper treatment. Methods : Twelve children diagnosed with renal abscess from Jan. 1996 to Jul. 2004 were included. The age of patients ranged from S months to 15 years. We retrospectively analyzed the demographics of patients, their symptoms, predisposing factors, diagnostic methods and causative organisms and the treatment modalities. Results : Fever was the most common manifestation, Five children(42%) had vesicoureteral reflux. Renal ultrasonography and computerized tornography were the most frequently used imaging tools to detect renal abscess. Gram negative bacteria were isolated in 7 patients and Staphylococcus aureus grew in 2 patients. All patients received intravenous antibiotics and 4 patients underwent aspiration or drainage of renal abscess. The average admission duration was 30 days. Conclusion : Renal abscess should be included in the differential diagnosis of prolonged fever in children, especially when flank pain is combined. For early diagnosis and a better prognosis, patients should be promptly investigated with ultrasonography or computerized tomography.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.125-132
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• 2003

Purpose : Lipoprotein(a) is a genetically determined risk factor for atherosclerotic vascular disease and is elevated in patients with renal disease. Especially the patients with nephrotic syndrome exhibit excessively high Lp(a) plasma concentrations. Also the patients with end-stage renal disease have elevated Lp(a) levels. But the mechanism underlying this elevation is unclear. Thus, in this study, by measuring the level of serum Lp(a) in common renal diseases in children, we hoped to see whether there would be a change in Lp(a) in renal diseases other than nephrotic syndrome. Then, we figured out its implications, and looked for the factors that affect the Lp(a) concentrations. Methods : A total of 75 patients(34 patients with hematuria of unknown etiology, 10 with hematuria and hypercalciuria, 8 with IgA nephropathy, 8 with poststreptococcal glomerulone phritis, 3 with $Henoch-Sch\"{o}nlein$ nephritis, 7 with urinary tract infection, and 5 with or- thostatic proteinuria) were studied. The control group included 20 patients without renal and liver disease. Serum Lp(a), total protein, and albumin levels, 24-hour urine protein and calcium excretions, creatinine clearance and the number of RBCs and WBCs in the urinary sediment were evaluated. Data analysis was peformed using the Student t-test and a P-value less than 0.05 was considered to be statistically significant. Results : LP(a) was not correlated with 24-hour urine calcium and creatinine. Lp(a) level had a positive correlation with proteinuria and negative correlation with serum albumin and serum protein. Among the common renal diseases in children, Lp(a) was elevated only in orthostatic proteinuria (P<0.05). Conclusion : Lp(a) is correlated with proteinuria, serum protein, and serum albumin, but not with any kind of specific renal disease. Afterward, Lp(a) needs to be assessed in patients with orthostatic proteinuria and its possible role as a prognostic factor could be confirmed.

• Journal of Life Science
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• v.7 no.2
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• pp.142-148
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• 1997

This study was carried out to clarify seasonal changes of chemical compositions and their interrelation in leaves, shoots and berries treated with gibberellin($GA$_{3}$)for seedless grapes in ‘Delaware’grapevines. the clusters were dipped twice with 100ppm $GA_{3}$: 10 days befor and after the full bloom. The reaults obtained as follows; 1. Cumulative growth curve of berry fresh weight showed a double sigmoid curve and the characteristics of three distinctive growth stages(I, II, III)were weekened with $GA_{3}$ treatment. 2. while the contents of ash, total carbon, total nitrogen and total carbohydratd had little reation with edvelopment and ripeness of berries, those of total sugar and starch jad close relation, viz., they decreased with enlargement and maturity fo berries, but increased rapidly after harvest in leaves and shoots. Especially, total sugars in leaves and shoots decreased coincidently with starch-increasing in shoots at November. 3. The contents of total soluble solid and reducing sugar in berries increased rapidly at growth stage III, but those of total titratable acidity and organic acid decreased coincidently with sugar-increasing. 4. The berry-hardness increased until growth stage I, and then stagnated until gtowth stage II, and then increased rapidly at growth stage III. pH of berry-juice decreased until growth stageII, afterwards increased at growth stage III. 5. By correlation and path coefficient analysis between qualitative characters and the ratio of total soluble solid to titratable acidity($^{\circ}$Brix/Acidity), total correlation coefficients were all highly significant. Of these characters, pH and viscosity of berry-juice were positive, but brightness and hardness of berry, negative. The direct effect of pH on $^{\circ}$Brix/Acidity ratio, p4y=0.9090, was large positively and those of berry-hardness and juice-viscosity, p1y=0, 5938, median and, p2y=0, 3550, small, respectively. Direct effect of brightness was negatively small.

• Journal of Life Science
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• v.17 no.3 s.83
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• pp.386-395
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• 2007

A total of 27 strains of Vibrio parahaemolyticus (18 strains isolated from Korea and 9 strains from Japan) were serotyped and examined for biochemical characteristics, antimicrobial susceptibility patterns, cytotoxicity assay, thermostable direct hemolysin (TDH) production and molecular epidemiology. Using polymerase chain reaction (PCR) method and DNA probe hybridization method, the strains were tested for toxR, tdh, trh and ORF 8 genes. The V. parahaemolyticus isolated from patients were belonged to 8 different serotypes : O3:K6, O1:K38, O3:K57, O4:K9, O4:Kl2, O4:K68, O5:Kl5 and O6:K46. Urease-positive strain possessed the trh gene, and conversely, urease-negative strains lacked the gene, indicating that urease production by V. parahemolyticus strains strongly correlates with the possession of the trh gene. Most strains showed multiple resistant to more than three antibiotics and the antibiogram could be classified into 6 group (I to VI). All of the O3:K6 strains isolated in South Korea and Japan producted TDH at high levels. The TDH titers ranged between 256 and 2.048, and the average titer was 1009. To distinguish the new and increasingly common V. parahaemolyticus strains from clinical isolates, ORF 8 is a useful genetic marker. After Southern hybridization, the HindIII restriction fragment patterns of the tdh gene were grouped one type, respectively. One type showed two bands one of which was 4.3kb and the other was 11.5kb in size. Variation between the O3:K6 serotype are minor when compared to the differences seen with the non O3:K6 strains. The migration patterns of Not I -digested of the total DNA of the O3:K6 strains were similar, and only slight variations were observed between the serotypes. By contrast, the O3:K6 strains and non O3:K6 had markedly different profiles. In conclusion, Random amplified polymorphic DNA (RAPD) profile using appropriate primers was an effective epidemiological marker.

• Journal of Life Science
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• v.23 no.2
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• pp.228-236
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• 2013

This study was aimed at investigating whether dietary therapy using medicinal enzyme powder is effective in reducing constipation caused by loperamide in rats. Nine-week-old male Sprague Dawley were subdivided into 4 groups: normal diet group (C), loperamide treatment and normal diet (CL), medicinal enzyme powder diet (E), and loperamide treatment and medicinal enzyme powder diet (EL). Constipation was induced by subcutaneous injection of loperamide (1.5 mg/kg) 3 days prior to sacrifice. The treatment with loperamide led to an increase in weight gain, a decrease in the number and wet weight of fecal pellets, and a decrease in intestinal motility. The administration of the medicinal enzyme powder significantly reduced weight gain but increased intestinal mobility compared with the loperamide-treated group. The treatment with loperamide in the normal diet group reduced the activities of both suggesting that constipation may be involved in the low level of glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT). Additionally, the loperamide treatment in the medicinal enzyme powder diet group increased the level of GOT, but reduced the level of GPT. Loperamide treatment also reduced cholesterol and increased the atherogenic index (AI) and cardiac risk factors (CRFs). Interestingly, the treatment with the medicinal enzyme powder effectively attenuated both the increase in AI and the reduction in high density lipopretein (HDL)-cholesterol, caused by the treatment with loperamide. Although there were no significant differences in the blood protein level, including hemoglobin and hematocrit, between the normal diet group and the loperamide-treated group, the administration of the medicinal enzyme powder to the loperamide-treated group effectively increased the levels of both hemoglobin and hematocrit. Collectively, the results demonstrate that the medicinal enzyme powder can help to combat the negative events caused by constipation.

• Asia pacific journal of information systems
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• v.24 no.4
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• pp.493-513
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• 2014

With the development of related technologies, Location-Based Services (LBS) are growing fast and being used in many ways. Past LBS studies have focused on adoption of LBS because of the fact that LBS users have privacy concerns regarding revealing their location information. Meanwhile, the number of LBS users and revenues from LBS are growing rapidly because users can get some benefits by revealing their location information. Little research has been done on how LBS affects consumers' information search behavior in product purchase. The purpose of this paper is examining the effect of LBS information filtering on buyers' uncertainty and their information search behavior. When consumers purchase a product, they try to reduce uncertainty by searching information. Generally, there are two types of uncertainties - knowledge uncertainty and choice uncertainty. Knowledge uncertainty refers to the lack of information on what kinds of alternatives are available in the market and/or their important attributes. Therefore, consumers having knowledge uncertainty will have difficulties in identifying what alternatives exist in the market to fulfil their needs. Choice uncertainty refers to the lack of information about consumers' own preferences and which alternative will fit in their needs. Therefore, consumers with choice uncertainty have difficulties selecting best product among available alternatives.. According to economics of information theory, consumers narrow the scope of information search when knowledge uncertainty is high. It is because consumers' information search cost is high when their knowledge uncertainty is high. If people do not know available alternatives and their attributes, it takes time and cognitive efforts for them to acquire information about available alternatives. Therefore, they will reduce search breadth. For people with high knowledge uncertainty, the information about products and their attributes is new and of high value for them. Therefore, they will conduct searches more in-depth because they have incentive to acquire more information. When people have high choice uncertainty, people tend to search information about more alternatives. It is because increased search breadth will improve their chances to find better alternative for them. On the other hand, since human's cognitive capacity is limited, the increased search breadth (more alternatives) will reduce the depth of information search for each alternative. Consumers with high choice uncertainty will spend less time and effort for each alternative because considering more alternatives will increase their utility. LBS provides users with the capability to screen alternatives based on the distance from them, which reduces information search costs. Therefore, it is expected that LBS will help users consider more alternatives even when they have high knowledge uncertainty. LBS provides distance information, which helps users choose alternatives appropriate for them. Therefore, users will perceive lower choice uncertainty when they use LBS. In order to test the hypotheses, we selected 80 students and assigned them to one of the two experiment groups. One group was asked to use LBS to search surrounding restaurants and the other group was asked to not use LBS to search nearby restaurants. The experimental tasks and measures items were validated in a pilot experiment. The final measurement items are shown in Appendix A. Each subject was asked to read one of the two scenarios - with or without LBS - and use a smartphone application to pick a restaurant. All behaviors on smartphone were recorded using a recording application. Search breadth was measured by the number of restaurants clicked by each subject. Search depths was measured by two metrics - the average number of sub-level pages each subject visited and the average time spent on each restaurant. The hypotheses were tested using SPSS and PLS. The results show that knowledge uncertainty reduces search breadth (H1a). However, there was no significant correlation between knowledge uncertainty and search depth (H1b). Choice uncertainty significantly reduces search depth (H2b), but no significant relationship was found between choice uncertainty and search breadth (H2a). LBS information filtering significantly reduces the buyers' choice uncertainty (H4) and reduces the negative relationship between knowledge uncertainty and search breadth (H3). This research provides some important implications for service providers. Service providers should use different strategies based on their service properties. For those service providers who are not well-known to consumers (high knowledge uncertainty) should encourage their customers to use LBS. This is because LBS would increase buyers' consideration sets when the knowledge uncertainty is high. Therefore, less known services have chances to be included in consumers' consideration sets with LBS. On the other hand, LBS information filtering decrease choice uncertainty and the near service providers are more likely to be selected than without LBS. Hence, service providers should analyze geographically approximate competitors' strength and try to reduce the gap so that they can have chances to be included in the consideration set.

• The Korean Journal of Nuclear Medicine
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• v.39 no.1
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• pp.21-25
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• 2005

Purpose: $^{14}C$-urea breath test (UBT) is a non-invasive and reliable method for the diagnosis of Helicobacter pylori (HP) infection. In this study, we evaluated the diagnostic performance of a new and rapid $^{14}C$-UBT (Heliprobe method), which was equipped with $Geiger-M\ddot{u}ller$ counter and compared the results with those obtained by using the conventional method. Materials and Methods: Forty-nine patients with dyspepsia underwent gastroduodenoscopy and $^{14}C$-UBT. A 37 KBq $^{14}C$-urea capsule was administered to patients and breath samples were collected. In Heliprobe method, patients exhaled into a Hellprobe BreathCard for 10 min. And then the activities of the BreathCard were countered using Heliprobe analyzer. In the conventional method, results were countered using liquid scintillation counter. During gastroduodenoscopy, 18 of 49 patients were underwent biopsies. According to these histologic results, we evaluated the diagnostic performance of two different methods and compared them. Also we evaluated the concordant and disconcordant rates between them. Results: In all 49 patients, concordant rate of both conventional and Heliprobe methods was 98% (48/49) and the discordant rate was 2% (1/49). Thirteen of 18 patients to whom biopsies were applied, were found to be HP positive on histologic results. And both Heliprobe method and conventional method classified 13 of 13 HP-positive patients and 5 of 5 HP-negative patients correctly (sensitivity 100%, specificity 100%, accuracy 100%). Conclusion: The Heliprobe method demonstrated the same diagnostic performance compared with the conventional method and was a simpler and more rapid technique.